CPG for Psychosocial Interventions in Severe Mental ... - GuíaSalud

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Respect to ICM teams organised in agreement with the ACT model, they were more likely
to reduce the use of hospital care, but this finding was not encountered when analysing
the personnel levels recommended for ACT 207 .
There are no differences between non-acute day hospitals and outpatients treatment for
people with SMI, with respect to readmission rates, mental state and social functioning 8 .
People who receive Case Management are more likely to remain in contact with the services
and improve medication adherence 205 .
There are no differences with respect to social functioning, improvement of mental state,
quality of life, imprisonment between CM and ST in people with SMI 205 .
Recommendations
B
When people with SMI need to be readmitted several times into acute units, and/or there
is a past history of difficulties to engage with the services with the subsequent risk of
relapse or social crisis (as for example becoming a “homeless” person) it is advisable to
provide assertive community treatment teams.
The continuity of the treatment must be favoured via the integration and coordination of
the use of the different resources by the people with SMI, maintaining continuity of care
and interventions, and in the psychotherapeutic relations established.
Care must be maintained from the perspective of the CMHC as a configuration of the
most commonly implemented services in our context, based on teamwork, on service
integration and not losing the perspective of being able to integrate other ways of configuring
the services that might be developed.
When the needs of the people with SMI cannot be covered from the CMHC, continuity of
assistance must be given from units that provide day care, and whose activity is organised
around the principles of psychosocial rehabilitation, whatever the name of the resource
are (Day Centres, Psychosocial Rehabilitation Centres, etc.).
A certain level of care can be offered to people with SMI whose needs cannot be satisfied
by resources that provide day-care in rehabilitation orientated residential resources
whatever the name of the resource are (hospital rehabilitation units, medium stay units,
therapeutic communities, etc.)
CLINICAL PRACTICE GUIDELINES FOR PSICHOSOCIAL INTERVENTIONS IN SEVERE MENTAL ILLNESS 101